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Individual

BASIL DALAVAGAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M. D.

Contact information

Practice address
95 UNIVERSITY PL, 8TH FLOOR, NEW YORK, NY 10003-4515
(212) 604-1361
(212) 604-1379
Mailing address
95 UNIVERSITY PL, 8TH FLOOR, NEW YORK, NY 10003-4515
(212) 604-1361
(212) 604-1379

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
117409
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00507039
NY
Enumeration date
05/18/2006
Last updated
07/08/2007
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